MEDICARE: LYNN GIONFRIDDO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03215392	OH

General Provider Information

NPI Number	:	1265824759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN GIONFRIDDO

Provider Business Mailing Address
First Line	:	7300 YANKEE RD
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9168
Country	:	US
Telephone Number	:	513-342-3260
Fax Number	:	513-342-3261

Provider Business Practice Location Address
First Line	:	7300 YANKEE RD
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9168
Country	:	US
Telephone Number	:	513-342-3260
Fax Number	:	513-342-3261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2015
Last Update Date	:	02/20/2015

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Directions to “ LYNN GIONFRIDDO ” Practice Location

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